The impact of immunohistochemical expression of nitric oxide synthases on clinical and pathological features of renal cell carcinoma

Purpose To evaluate the immunohistochemical expression of nitric oxide synthase (NOS) types 1, 2, and 3 in intratumoral and non-neoplastic samples of renal cell carcinoma (RCC) and correlate it with the clinical and pathological features of this malignancy. Methods We analyzed 110 patients with RCC...

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Published in:	World journal of urology Vol. 31; no. 5; pp. 1197 - 1203
Main Authors:	Cássio Zequi, Stênio de, Fregnani, José Humberto G. T., Favaretto, Ricardo L., Costa, Walter H., Madeira Campos, Rodrigo S., Fonseca, Francisco P., Guimaraes, Gustavo C., Soares, Fernando A., da Cunha, Isabela W., Lopes, Ademar
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-10-2013 Springer Nature B.V
Subjects:	Adult Aged Aged, 80 and over Carcinoma, Renal Cell - metabolism Carcinoma, Renal Cell - pathology Carcinoma, Renal Cell - surgery Female Humans Immunohistochemistry Kidney - metabolism Kidney - pathology Kidney - surgery Kidney Neoplasms - metabolism Kidney Neoplasms - pathology Kidney Neoplasms - surgery Male Medicine Medicine & Public Health Middle Aged Neoplasm Invasiveness Neoplasm Staging Nephrectomy Nephrology Nitric Oxide Synthase Type I - metabolism Nitric Oxide Synthase Type II - metabolism Nitric Oxide Synthase Type III - metabolism Oncology Original Article Prognosis Retrospective Studies Survival Rate Treatment Outcome Urology Immunohistochemistry Nitric oxide synthase Renal cell carcinoma NOS 3 Survival Prognostic
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Summary:	Purpose To evaluate the immunohistochemical expression of nitric oxide synthase (NOS) types 1, 2, and 3 in intratumoral and non-neoplastic samples of renal cell carcinoma (RCC) and correlate it with the clinical and pathological features of this malignancy. Methods We analyzed 110 patients with RCC underwent radical nephrectomy (RN) or partial nephrectomy (PN) by streptavidin–biotin peroxidase method, tissue microarray, and digital microscopy. As endpoints, NOS expression was correlated with pathological features, overall survival (OS), and cancer-specific survival (CSS). Results Non-neoplastic samples had higher NOS3 and lower NOS 2 levels than RCC tissues. Greater expression of all NOS isoforms was associated with larger tumors. High NOS1 expression correlated with microscopic venous invasion (MVI) ( p = 0.046) and lymph node metastases ( p = 0.007). High NOS2 expression was linked to MVI, more RN performed, and male gender ( p = 0.035, p = 0.003, and p = 0.027, respectively). High NOS3 expression correlated with lymph node metastases ( p = 0.039), microlymphatic invasion ( p = 0.029), invasion of the renal pelvis and ureter ( p = 0.004), RN ( p = 0.003), and shorter OS (58.1 vs. 79.4 % respectively, p = 0.033) by univariate analysis. DFS was not influenced by any NOS isoform. By multivariate analysis, the risk factors for death were TNM stages III and IV (hazard ratio [HR] = 4.5), high Fuhrman’s grade (HR = 2.9), Karnofsky performance status ≤80 (HR = 2.5), progression (HR = 5.5), and recurrence (HR = 6.3). Stage III disease was an independent risk factor for recurrence (HR = 9.5). Conclusions High NOS expression in RCC is associated with a poor prognosis and larger tumors. NOS3 influences OS by univariate analysis.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0724-4983 1433-8726
DOI:	10.1007/s00345-012-0878-1